Over the past 3 years, the Research Project 4 (RP4) Investigators have assembled a cohort of[unreadable] asthmatics and studied their respiratory responses to Florida red tide by comparing exposure and nonexposure[unreadable] periods. We have demonstrated statistically significant changes in inflammatory markers,[unreadable] respiratory function and reported symptoms in asthmatics with only 1 hour of acute beach exposure; no[unreadable] significant changes were observed during similar non-exposure periods. Parallel to these studies, the[unreadable] Investigators have assisted the Centers for Disease Control and Prevention (CDC) and the Florida Dept[unreadable] of Health (FDOH) in assembling and evaluating an occupational cohort. This represents the first time that[unreadable] possible health effects from exposure to aerosolized Florida red tide toxins have been evaluated[unreadable] epidemiologically in human populations.[unreadable] Over the next 5 years, working with the Toxin Probes and Assays Core, the Field Logistics and Development Core, and Project by Cheng, we propose[unreadable] to continue studying the exposures and health effects for humans due to aerosol exposures to Florida[unreadable] Red Tide, using new measures of exposure and physiologic effects. Specifically, we will annually collect[unreadable] pre- and post-exposure health effects and environmental exposure data at a time when a Florida red tide[unreadable] occurs and at a time with no Florida red tide for 1 hour of beach exposure. In addition, the investigators[unreadable] will annually conduct a 5 day Follow-up Study directly following the 1 hour Acute Exposure Study to[unreadable] collect data on persistent and delayed health effects from the acute exposure, as well as from possible[unreadable] repetitive exposures to Florida red tides toxins over 5 days. Additional data will be collected every 6[unreadable] months to evaluate the severity and controllability of the asthmatics in the prior 6 months. The data from[unreadable] these annual studies (exposed and unexposed) will be evaluated longitudinally to explore possible[unreadable] chronic effects of varying Florida red tide toxin levels on the health of asthmatics, as well as[unreadable] subpopulations among the asthmatics.[unreadable] Based on the results of the animals models ( Projects by Benson and Abraham) and our epidemiologic work, we[unreadable] will use the following measurable physiologic effects: reported symptoms and measures of asthma[unreadable] controllability, spirometry, nasal swabs for inflammatory mediators, and exhaled condensates for[unreadable] acidification and selected cytokines, as well as the exposure measures of environmental and personal[unreadable] monitoring and nasal swabs for brevetoxins. The possible association between the uncontrollability of[unreadable] asthma associated with Florida red tide toxin exposure over time will be evaluated. In addition, the[unreadable] possible dose response relationship will be explored between long term exposure to Florida red tide[unreadable] toxins and their effects on measurable physiologic effects in asthmatics by evaluating coastal vs inland[unreadable] residents. Over the proposed 5 years, the project investigators will also take advantage of advancements in[unreadable] the science made by the other Projects to refine methods for measuring human exposures and[unreadable] physiologic effects from this environmental occurrence. The data from these studies will provide[unreadable] valuable medical and public health information concerning acute, subacute and chronic respiratory[unreadable] effects of aerosolized red tide toxin exposures annually in asthmatics over a 5 year period.[unreadable]